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Table 3 Criteria for holding and stopping IL2 #

From: High dose interleukin-2 (Aldesleukin) - expert consensus on best management practices-2014

System Relative criteria Absolute criteria
Cardiovascular Sinus tachycardia 100-130 BPM* Sinus tachycardia > 130 BPM*
ECG indications of ischemia
Atrial fibrillation
Supraventricular tachycardia
Ventricular arrhythmias**
Elevated CKB-MB isoenzyme of troponin levels
Dermatologic Moist desquamation  
Gastrointestinal Diarrhea, 1000 ml/shift Diarrhea 1000 ml/shift x 2
Vomiting not responsive to medication
Ileus/abdominal distention Severe abdominal distention affecting breathing
Bilirubin > 7 mg/dL Severe, unrelenting abdominal pain
Hemodynamic#* Maximum Phenylephrine 1-1.5 mcg/kg/min Maximum Phenylephrine 1.5-2.0 mcg/kg/min
Minimum Phenylephrine > 0.5 mcg/kg/min Minimum Phenylephrine > 0.8 mcg/kg/min
Hemorrhagic Sputum, emesis, or stool heme-positive Frank blood in sputum, emesis, or stool
Platelets 30,000-50,000/mm3 Platelets < 30,000 mm3
Infectious   Strong clinical suspicion or documented
Musculoskeletal Weight gain > 15%  
Extreme tightness Extreme paresthesias
Neurologic Vivid dreams Hallucinations
Mild anxiety Persistent crying
Mental status changes not reversible in 2 hours
Unable to subtract serial "7 s" or spell "WORLD" backward
Pulmonary Resting shortness of breath > 4 L O2 by nasal cannula or 40% by mask to maintain ≥ 95% O2 saturation
3- 4 L O2 by nasal cannula for O2 saturation ≥ 95% Intubation
Rales 1/3 up chest Moist rales ½ up chest
Renal Urine output 80-160 ml/shift Urine < 80 ml/shift
Creatinine 2.5-2.9 mg/dL Creatinine ≥ 3 mg/dL
HCO3 ≤ 18 meq/dL
  1. Abbreviations: BPM, beats per minute; ECG, electrocardiogram.
  2. *Persistent at the time of dosing after correcting hypotension, fever, and tachycardia and discontinuing dopamine.
  3. **Including premature ventricular contractions, bigeminy, and tachycardia.
  4. #In order to maintain acceptable BP and pulse criteria.
  5. *Phenylephrine Max is during the interval, Min at the time of dosing.
  6. #The above criteria should be assessed at the scheduled time of next dose after aggressive measures to correct toxicity have been undertaken.
  7. If ≤ 3 relative criteria, delay dosing, continue corrective measures and administer another dose if recovered in < 24 hours.
  8. If >3 relative criteria or an absolute criteria are observed stop IL-2 for the current cycle.